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Thread: PT as a treatment of scoliosis

  1. #1
    Join Date
    Mar 2014
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    PT as a treatment of scoliosis

    Hy guys, let me first introduce myself. I'm 21 years old male with idiopathic scoliosis, 37° lumbar(L4-T12) and 40° thoracic(T12-T5). Haven't had any pain in my back ever in my life, just some discomfort from deformity and strange feeling at the end of the day, feels like muscles get tired and can't really keep my spine upright. Damn gravity Sooo...my main worry now is my future, and stability or instability of my scoliosis. If I would remain like this all my life, i would't even think about surgery, at least not now with today's surgery techniques. I also hope that I will endure 20-30 more years and by then the surgical techniques will evolve enough and there will be more secure outcomes of these procedures. Enough of these...let's get to the point.
    I would be gratefull if KevinMc could participate in the discussion because he is working in this territory.
    My logical understanding makes me think that proper excercises could be beneficial in term of stabilizing the spine and avoiding progression at least in mature spine and moderate curves around 50°. I can only think of gravity being a problem in mature spine and reason for progression. Also, bone remodeling is possible and it surely happens with the curve progression after maturity, so if it can go one way, it must be possible to go another way also(in theory,it is more complicated in real world), or at least stay as it is.
    This is my idea, and i tried to do it, and it feels sooo good- with side shift you can correct curves in frontal plane, with Schroth breathing you can derotare your thoracic spine and you also pay attention to your saggital profile. And do these all at the same time so you get 3D correction.
    What interests me, and I think Kevin can help here, is which muscles are surrounding the spine and which muscles have the greatest impact on spine stability.
    My idea is to incorporate 3D correction with some kind of strenghtening excercises, so that the muscles and in part ligaments "remember" what is their right position. Something like this: sit in torso rotation machine, put some kind of lift under my left buttock to reduce left lumbar curve, shift my torso to reduce thoracic curve, take deep breath in my thoracic concave side and upper part of lungs to derotate and lenghten my spine and then perform one repetition of torso rotation, back in starting position and all of these steps again until you aren't comfortable with doing another repetition, increase wight over time to boost your strenght and encurance. And also make couple of other excercises on the same scheme like this. I'm also interested in Alexander technique but that is another story... It would be great to hear from other people what they think about this and maybe give their own ideas for discussion.

    PS: I know that researches conducted by the medical comunity say that PT does not have any influence on curve natural history but I think that these researces were not done correctly and are missleading, you have to know that your patients are really doing their excercises. Torso rotation research from dr. McIntire shows promise although it is done on relatively small number of patients. If I knew about this back then, this would be my first option in my treatment.
    Really good research haven't even been done for brace effectiveness, and it is funny to even talk about PT research. This is just a discussion from lay people so don't get this too serious and please don't write "where is the evidence for this or that". Looking forward to hear some opinions

  2. #2
    Join Date
    Dec 2009
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    17
    I agree .....there are some small studies out there...keep searching and you will find them. But, the most important to me, is my own daughter's experience so far. She had started working on a torso rotation machine at a gym close to our home, and felt it was helping her be "straighter". The gym closed, and we are now scrambling to find a Med X torso rotation machine, as it locks in the pelvic area. She is now starting to be in pain, as she has not used the machine since the closing of the gym 3 weeks ago. We do know of another gym with a Med x TR machine, but it is about an hour and a half away from us and the ride is not a pleasant one....lots of heavy semi trailer truck traffic and it can turn into over 2 hours each way with traffic, so I have been trying to source a TR closer to us. She is 19, and the fact that she is willing and eager, and now demanding we travel to Philly to use this machine is proof enough for me the TR has helped her!

    And yes, bones can and do move. At least, that is what my orthodontist told me. I think that's why braces work, even in adults.

  3. #3
    Join Date
    May 2009
    Posts
    3,577
    bones in the jaw and bones in the body are different
    and work differently....
    i am having extensive dental implant work done....with bone
    grafting....
    i discussed scoliosis with my periodontist and implant specialists.

    i think the title of this thread is very misleading

    jess...and Sparky

  4. #4
    Join Date
    Mar 2014
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    12
    Hy Nim, I am glad to hear that TR is helping your daughter with her pain. May I ask which degree of curve and location of the curve does she have?
    Hy Jess, I am sorry if title sounds a bit like SF, I didn't meant to sound like that. I don't speak english very well so I couldn't find better words for it. If it is so missleading I would be gratefull if moderators could change it. At the end of post I wrote that it is just some toughts of lay people and don't take these words too seriously. I read forum a lot for the past year and I know that you are in tough situation and am really sorry for you, hope that you will find some relief for yourself in conservative methods or surgicaly. Worst thing for us is to believe we can't do anything to improve our condition, and we get that impression from medical comunity. Wish you all the best, hugs to Sparky
    I find myself feeling much better mentally and phisycaly when I am being active and excercising. Our bodies are made to move, to lift, to be phisicaly active, not to sit in front of TV and computer all day. I had periods where i would sink in depression because of my condition and that mental state is very terifying and certeanly is not good. Now I find my scoliosis inspirative and it keeps me moving forward, I want to make my body function the best it can with this condition, I want to make my body strong and resistant. I think that all of us scolis have that feeling that in part it is our fault that we are here where we are now, so do something today so you don't regret tommorow.
    If someone has some kind of their own regimen of excercises which makes them feel better and improves their pain, it would be great to hear that
    And yes, dr. McIntire, chime in!

  5. #5
    Join Date
    Jan 2008
    Location
    Oregon
    Posts
    983
    One member here successfully purchased a used/good condition MedX torsion rotation machine from Craigslist for something like $150. Maybe you could find one for your daughter that way. Also some exercise machine stores sell used/reconditioned exercise machines…just a suggestion.

    Best regards,
    Gayle, age 46
    Boston brace as a teen for AIS
    Oct 2010 fusion T8-sacrum w/ pelvic fixation, TLIF at L4/5.
    Feb 2012 major A/P revision for broken rods


    mom of Leah, 12 y/o, diagnosed Jan '08 with 26* thoracic JIS (age 6)
    4/08 26 degrees, brace 16 hrs/day
    9/08 17 deg. OOB - brace discontinued
    9/09 30 deg, resuming brace
    5/10 VBS Dr Luhmann Shriners St Louis
    5/14 stable 4 yrs post-op, 14* T

    also mom of Torrey, 9 y/o son, 12* T, decreasing spontaneously (from 19*)

  6. #6
    Join Date
    May 2009
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    3,577
    thanks for the kind words, boogaloo...

    i wish anyone and everyone with scoliosis the best....
    and anything that can help people feel better is great....
    what i meant about misleading is that the title makes it
    sound as if PT is an alternative treatment for scoliosis...
    reducing curves is a monumental task....
    if curves could be changed easily, no one would ever
    opt for surgery.

    Sparky sends you woofs...
    jess

  7. #7
    Join Date
    Dec 2009
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    17
    I don't think the title is misleading. People DO use physical therapy and/or exercise as a treatment for their scoliosis. As of this date, my daughter is using it as a treatment for her scoliosis.....whether she continues remains to be seen. One of the main problems with PT and exercises is patient compliance. People start it, start to feel better, and then stop or do not do it that often. For many people sticking to an exercise program is very difficult, same way eating healthy and exercising is very difficult for some people that need to lose weight.

    And also, I think for people that DO stick to PT/exercise for their scoliosis because they find that it has helped them and for whatever reason their scoliosis did not progress enough to warrant surgery, well.......You just don't hear about those people.....They continue living with their scoliosis and continue doing their exercise or PT routine, and we don't really know if it is the exercise/PT they have been doing or was their scoliosis just not going to progress any farther even if they had done nothing. They probably do not even talk about it. They have scoliosis, they found something they feel has kept it from progressing and keeps them strong, and that's the end of the story, so we're not going to hear from these people. They're living their life, not lurking or reading on scoliosis forums.

  8. #8
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    Mar 2014
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    Nim I completely agree with all you said. And then I usually see comments like: if correction or stabilization of scoliosis is PT dependant, will you do these excercises for the rest of your life every day. For sake of god YES! If I need to do half an hour of excercises every day to avoid fusion and all possible complications and possible further surgeries than my answer is clear. To ask that kind of question is completely ridiculous, a lot of people with straight spines are excercising every day for their general health.
    I must say this, and I am sorry if someone finds himself offended. Reason why I had some depression periods and felt bad is in part this forum. Some people here just keep telling that there is no proof for this or there is no proof for that. Where is the proof that God exists? Some things are a matter of belief and logical thinking. They talk about "cutting loses", like it is better to fuse earlier to save levels even if curve is not in surgical range and is not progressing at the moment.
    They keep posting cases where people under 40° or even less progress to surgical range. Sometimes it happens but it is rare, like you get smashed by speeding car. And no one posted a case of TwistedLifter who has 70° curve and his curve is stable and that is way beyond 50° mark. You read the posts, and all you can read is about people who had scoliosis like teenagers and progressed to surgery, some of them had revision surgeries and further problems. That is the problem because you get the impression that it is the rule for us in the "grey area". And then you think you are going to progress, and I think mind plays a huge role in all medical problems.
    And the thruth is, people who don't have problems with their scoliosis or don't progress are not reading or posting on forums. And I think that moderators should state this LOUDLY, especialy Linda who is working in this field and has a lot of experience. This forum is supportive for those who are on the surgical road, but it is deffinitely not supportive for PT road because there is no "evidence". And people who are willing to do PT loose their hope by reading forum.
    Medicine couldn't explain a lot of things and certeanly doesn't want to find cures for some illnesses, big money is in the game you know.

    “Just look at us. Everything is backwards, everything is upside down. Doctors destroy health, lawyers destroy justice, psychiatrists destroy minds, scientists destroy truth, major media destroys information, religions destroy spirituality and governments destroy freedom.” – Michael Ellner
    Think about it.

  9. #9
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    Mar 2014
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    12
    And message to all of us scolis, who are not in tramendous pain or too much limited. Excercise, ride a bike, swim, walk, spend your free time in nature, just stay active. Try to excercise an hour a day for two months and you will find yourself feeling much better about yourself, you will become aware of what your body is capable to do, you will soon forget about your limitations. Don't worry too much, future is unpredictable, who knows what is coming down the road. Even if we do require surgery one day, your body will be ready for that stress and it could make all the difference in the world. Like TitaniumEd said, don't let the scoliosis leads your life, make it be just a small icon on the desktop. I am saying all this because I want to encourage people and I know how much "pain" can cause our bad mental state and negative attitude.
    Wish all the best to all of you guys!

  10. #10
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    Mar 2010
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    Quote Originally Posted by boogaloo View Post
    Hy guys, let me first introduce myself. I'm 21 years old male with idiopathic scoliosis, 37° lumbar(L4-T12) and 40° thoracic(T12-T5). Haven't had any pain in my back ever in my life, just some discomfort from deformity and strange feeling at the end of the day, feels like muscles get tired and can't really keep my spine upright. Damn gravity Sooo...my main worry now is my future, and stability or instability of my scoliosis. If I would remain like this all my life, i would't even think about surgery, at least not now with today's surgery techniques. I also hope that I will endure 20-30 more years and by then the surgical techniques will evolve enough and there will be more secure outcomes of these procedures. Enough of these...let's get to the point.
    I would be gratefull if KevinMc could participate in the discussion because he is working in this territory.
    My logical understanding makes me think that proper excercises could be beneficial in term of stabilizing the spine and avoiding progression at least in mature spine and moderate curves around 50°. I can only think of gravity being a problem in mature spine and reason for progression. Also, bone remodeling is possible and it surely happens with the curve progression after maturity, so if it can go one way, it must be possible to go another way also(in theory,it is more complicated in real world), or at least stay as it is.
    This is my idea, and i tried to do it, and it feels sooo good- with side shift you can correct curves in frontal plane, with Schroth breathing you can derotare your thoracic spine and you also pay attention to your saggital profile. And do these all at the same time so you get 3D correction.
    What interests me, and I think Kevin can help here, is which muscles are surrounding the spine and which muscles have the greatest impact on spine stability.
    My idea is to incorporate 3D correction with some kind of strenghtening excercises, so that the muscles and in part ligaments "remember" what is their right position. Something like this: sit in torso rotation machine, put some kind of lift under my left buttock to reduce left lumbar curve, shift my torso to reduce thoracic curve, take deep breath in my thoracic concave side and upper part of lungs to derotate and lenghten my spine and then perform one repetition of torso rotation, back in starting position and all of these steps again until you aren't comfortable with doing another repetition, increase wight over time to boost your strenght and encurance. And also make couple of other excercises on the same scheme like this. I'm also interested in Alexander technique but that is another story... It would be great to hear from other people what they think about this and maybe give their own ideas for discussion.

    PS: I know that researches conducted by the medical comunity say that PT does not have any influence on curve natural history but I think that these researces were not done correctly and are missleading, you have to know that your patients are really doing their excercises. Torso rotation research from dr. McIntire shows promise although it is done on relatively small number of patients. If I knew about this back then, this would be my first option in my treatment.
    Really good research haven't even been done for brace effectiveness, and it is funny to even talk about PT research. This is just a discussion from lay people so don't get this too serious and please don't write "where is the evidence for this or that". Looking forward to hear some opinions
    Boogaloo, it's really a nice surprise to find here someone thinking in this way.. we have a lot to talk.

  11. #11
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    Mar 2010
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    Quote Originally Posted by Nim View Post
    I don't think the title is misleading. People DO use physical therapy and/or exercise as a treatment for their scoliosis. As of this date, my daughter is using it as a treatment for her scoliosis.....whether she continues remains to be seen. One of the main problems with PT and exercises is patient compliance. People start it, start to feel better, and then stop or do not do it that often. For many people sticking to an exercise program is very difficult, same way eating healthy and exercising is very difficult for some people that need to lose weight.

    And also, I think for people that DO stick to PT/exercise for their scoliosis because they find that it has helped them and for whatever reason their scoliosis did not progress enough to warrant surgery, well.......You just don't hear about those people.....They continue living with their scoliosis and continue doing their exercise or PT routine, and we don't really know if it is the exercise/PT they have been doing or was their scoliosis just not going to progress any farther even if they had done nothing. They probably do not even talk about it. They have scoliosis, they found something they feel has kept it from progressing and keeps them strong, and that's the end of the story, so we're not going to hear from these people. They're living their life, not lurking or reading on scoliosis forums.
    EXACTLY! I know really many cases just only in my country.

  12. #12
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    Mar 2010
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    Boogaloo, did you see this? http://www.uvm.edu/~istokes/pdfs/JSPD24.pdf
    Exercises has very much to do with this concept!

  13. #13
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    ny
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    Quote Originally Posted by boogaloo View Post
    And message to all of us scolis, who are not in tramendous pain or too much limited. Excercise, ride a bike, swim, walk, spend your free time in nature, just stay active. Try to excercise an hour a day for two months and you will find yourself feeling much better about yourself, you will become aware of what your body is capable to do, you will soon forget about your limitations. Don't worry too much, future is unpredictable, who knows what is coming down the road. Even if we do require surgery one day, your body will be ready for that stress and it could make all the difference in the world. Like TitaniumEd said, don't let the scoliosis leads your life, make it be just a small icon on the desktop. I am saying all this because I want to encourage people and I know how much "pain" can cause our bad mental state and negative attitude.
    Wish all the best to all of you guys!
    Excellent advice - and much of it (maintaining a positive mental state, not allowing a single challenge to overtake your life, doing things that make you feel good about yourself) can be applied not only to scoliosis but to life in general!!
    mariaf305@yahoo.com
    Mom to David, age 15, braced June 2000 to March 2004
    Vertebral Body Stapling 3/10/04 for 40 degree curve (currently holding around 26 degrees)
    Under care of Dr. Randal Betz since 2004

    Also mom to Nicole (22) and Danny (25)

    Link to VBS Website: www.vertebralstapling.com

    Janet Cerrone, PA to Dr. Betz janetcerrone@spineandscoliosis.com or (609) 912-1500

  14. #14
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    Jan 2008
    Location
    NC
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    My concern with conservative treatments like bracing and PT is that if the child (or adult for that matter) doesn't comply 100% for 100% of the time, if they do eventually need surgery they might blame themselves for "failing" when the treatment itself might have failed them had they been 100% compliant. It's one thing to stay positive. But it is another thing, especially with a child, to browbeat them with the threat of surgery if they don't comply. And then the kid is completely around the bend if they do need surgery because they have been spooked against it by people they trust. Surgery must be the worst thing in the world if their parents were constantly browbeating them against it. That makes it more harrowing than it is.

    The problem is not parents staying positive for their kids. I think the problem is parents being too positive beyond what the evidence warrants.
    Last edited by Pooka1; 06-21-2014 at 10:35 AM.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  15. #15
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    Mar 2010
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    Quote Originally Posted by Nim View Post
    They have scoliosis, they found something they feel has kept it from progressing and keeps them strong, and that's the end of the story, so we're not going to hear from these people. They're living their life, not lurking or reading on scoliosis forums.
    This is the evidence we need to know.. there is not something as a giant Data Base where we can see all the cases around the world.. we must to look for them in the real world!

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